Understanding Men and Health: Masculinities, Identity, and Well-being

International Journal of Men's Health, Summer, 2009 by Jack H. Noone

Understanding Men and Health." Masculinities, Identity, and Well-being, by Steve Robertson. Berkshire, England: Open University Press, 2007, xii, 178 pp.

Understanding Men and Health examines how social context influences the relationship between masculine identities and conceptions of health for 20 lay men residing in Blackpool, England. Robertson employs theories of embodiment and hegemonic masculinity to elucidate differences in gay, disabled, and contingently able-bodied and straight men's accounts of health, how they engage in good (and bad) practices affecting their health, and how these practices are influenced by perceptions of masculinity, personal relationships, and the context of their everyday lives. The inclusion of seven health practitioners' accounts of men's health and men's talk around power relationships, health promotion, and their own medical experiences completes an informative and valuable analysis within the men's health field.

Robertson begins with a compelling argument against the homogenisation of men and their positioning as irresponsible and ignorant of health issues in the current literature. He suggests that men's health promotion is ill-informed as a result and cites this as one reason why men continue to experience poorer health outcomes than women. The author's approach to this problem is a focus on men's health, rather than ill-health, and an examination of the differences among various lay men's accounts of health, as well as how these differ from expert accounts. After the theoretical framework is introduced, the author details the embodied and gendered nature of the men's accounts of their health practices and examines the influence of personal relationships on their mental and physical health. In the final chapter, masculine ways of doing health are discussed alongside men's healthcare utilisation and men's resistance to some health promotion initiatives, but also their positive acceptance of others. Robertson's conclusions are clear and convincing: to improve the status of men's health, we must further understand the impact of masculine identities on men's health practices.

An important element of this book is the identification of specific dilemmas or tensions within the men's narratives. For example, many talk about control (eating well) versus release (binge drinking) as a way of maintaining a 'healthy lifestyle," while issues of risk (driving fast) versus responsibility (looking after one's health) clearly highlight the difficulties many men face in identifying as both masculine and virtuous, healthy citizens. Robertson considers these differences in terms of hegemonic, subordinated, and marginalised forms of masculinity by illustrating how alternative ways of doing health become available for the different groups of men.

Discrepancies between men's and practitioners' perceptions of the male body are another key finding recounted in this book. While many men spoke of knowing and listening to their bodies, a number of practitioners positioned men as uninterested and unlikely to look at their bodies beyond a mechanistic perspective. The author argues that in order to encourage health change, practitioners must pay greater attention to men's experiences of their bodies. This will help to ensure that practitioners' work towards promoting better health behaviours is in harmony with men's everyday lives. This finding will be of great interest to academics, health promoters, and practitioners alike.

Although the attention paid to men's voices is commendable, this book would have benefitted from more of the author's own comments on the men's accounts. Masculine identities are seldom constructed in isolation. They are the product of two or more parties in a situated context. This is especially important considering the book's focus on social context and its relevance for healthcare practitioners. Some examples of reflexive work may have helped these groups to better understand how their own talk can position their male patients in different ways, either encouraging or discouraging them from seeking help in the future.

Robertson has undertaken the difficult task of writing for both academics and health practitioners. While the concepts of embodiment and hegemonic masculinity may not be easily digested by all, the arguments presented in this book will appeal to many readers. For academics, it provides empirical evidence of masculine identity construction in a health-related context. For healthcare promoters and practitioners, it spells out the dangers of constructing men as ignorant and irresponsible and suggests that the "go in for an oil change" approach to men's health promotion is too simplistic. This book also provides a starting point for health practitioners to further understand how men actually conceive their health and their bodies.

For me, this work confirms that all men do not approach health in the same way. Conceptions of the body are complex, as are identities and decisions about health-related behaviours. Thus, the homogenisation of men as uninterested in their health will do little to improve men's overall health status. The evidence presented here indicates that the way men "do health" is dependent on their circumstances, which may or may not remain constant over time. It is these circumstances or contexts which must be explored further, if we are to better understand the complexities of men's health and how they are related to masculine identities.